Nakamura S, et al. - Axial computed tomography scans and an axial radiograph were taken in 115 consecutive knees following total knee arthroplasty (TKA) by the researchers in order to investigate the impact of the tibial tubercle-trochlear groove (TT-TG) distance and component rotation on patellar tilt and patellar shift following TKA. A notable association of TT-TG distance with patellar tilt in extension, patellar tilt in flexion, and the patellar shift was found. In flexion and patellar shift, the tibial component rotation was significantly related to the patellar tilt. No meaningful relationships were observed for the femoral component rotation. The tibial component rotation had an important association with TT-TG distance, whereas no correlation was discovered for the femoral component rotation. In conclusion, TT-TG distance had a significant relationship with the patellar tilt and patellar shift. Thus, factors influencing TT-TG distance should be taken into account by the surgeons. Moreover, they should pay consideration to avoid excessive TT-TG distance following TKA.